The effects of paroxetine therapy on depressive symptom and motor function in the treatment of depression with Parkinson’s disease: A meta-analysis

Abstract

Background: Paroxetine therapy has been used for treatment of patients with depression and Parkinson’s disease (dPD) in many clinical studies, but, the effects of paroxetine in dPD patients are not completely understood. The aim of this study was to systematically evaluate the effects of paroxetine therapy on depressive symptom and motor function in the treatment of dPD, in order to confer a reference for clinical practice. Methods: Randomized controlled trials (RCTs) of paroxetine for dPD published up to October, 2022 were retrieved. Standardised mean difference (SMD), odds ratio (OR), and 95% confidence interval (CI) were calculated and heterogeneity was measured with the I 2 test. The outcomes of interest were as follows: the efficacy, Hamilton depression rating scale score, unified Parkinson’s disease rating scale score, Hamilton anxiety rating scale score or adverse events. Results: Thirty-four RCTs with 2819 participants were included. Compared with control group, the pooled effects of paroxetine therapy on depression were (22 trials; OR 3.62, 95% CI 2.63 to 4.98, P < .00001) for antidepressant response (25 trials; SMD -2.14, 95% CI -2.73 to -1.56, P < .00001) for Hamilton depression rating scale score, the pooled effects of paroxetine therapy on motor function were (10 trials; OR 4.63, 95% CI 3.15 to 6.79, P < .00001) for anti-PD efficacy (18 trials; SMD -2.02, 95% CI -2.48 to -1.55, P < .00001) for total unified Parkinson’s disease rating scale score. The Hamilton anxiety rating scale score showed significant decrease in the paroxetine treatment group compared to control group (10 trials; SMD -1.93, 95% CI -2.65 to -1.22, P < .00001). In addition, paroxetine therapy reduced the number of any adverse events obviously in dPD patients (twenty trials; OR 0.42, 95% CI 0.31 to 0.57, P < .00001). Conclusions: Paroxetine therapy has clinical benefits for improvement of depressive symptom and motor function in dPD patients, moreover, it is of high drug safety. Further well-designed, multi-center RCTs needed to identify these findings.

Dopaminergic Changes in the Subgenual Cingulate Cortex in Dementia with Lewy Bodies Associates with Presence of Depression

“…Depression is also often present at prodromal DLB stages and persists throughout the clinical course (Fujishiro et al 2015;Kuring, Mathias, and Ward 2018). Depression in dementia is associated with poor quality of life, increased morbidity and more rapid cognitive decline and consequently treatment of depression would have significant patient benefit (Lenze et al 2005;Starkstein et al 1992;Breitve et al 2016;Boot et al 2013;Gatt et al 2017;Terum et al 2021;Jiang et al 2023;Christensen, Schmidt, and Grande 2023;Joshi et al 2022).…”